Since the first diagnosis in the United States in 1982, the human immunodeficiency virus (HIV) has become a global pandemic, with over 35 million people now living with the infection, including more than 1 million people in the US.
The Yale School of Public Health has a long history in research on the disease, starting with pioneering efforts in the late 1980s that led to the establishment of one of the first needle-exchange programs in the US to interrupt the transmission of the virus through intravenous drug use. The Yale School of Public Health has engaged deeply in research, training and service in response to HIV and related conditions such as addiction, Hepatitis C virus (HCV) and tuberculosis, both in Connecticut and globally.
In 1997, the Center for Interdisciplinary Research on AIDS (CIRA), New England's only National Institute of Mental Health (NIMH)-funded AIDS research center, opened at YSPH. It brings together and supports researchers in innovative, interdisciplinary work focused on the implementation of HIV prevention and treatment, along with the elimination of HIV disparities.
Today, many studies focus on the effects of stigma and lifestyle on HIV risk, especially among vulnerable populations such as the LGBTQ community, those experiencing interpersonal violence, sex workers, and persons who inject drugs. Additionally, the interaction of HIV with other chronic conditions such as hepatitis, tuberculosis and malaria is researched. Other work focuses on the HIV continuum of care, and how community research capacity can strengthen prevention and intervention efforts globally.
Practice- and community-based research and initiatives
Practice-based research and implementation science are at the heart of the mission of YSPH’s Center for Interdisciplinary Research on AIDS. Specific initiatives include:
The New England HIV Implementation Science Network, formed in collaboration with the Providence-Boston Center for AIDS Research, fosters academic-practice research collaborations through events and technical assistance. At annual symposia, held since 2014, approximately 100 HIV researchers have gathered with representatives from health departments, community agencies and clinical sites to build relationships and strategize research partnerships. Projects resulting from the Network have included grants funded by NIAID, NIMH and the CDC.
A partnership with APNH: A Place to Nourish Your Health (formerly AIDS Project New Haven) to develop and implement an intervention to engage young Black and Latino gay and bisexual men in HIV prevention. The project, Chat4Change, funded by the CDC and the CT Department of Public Health, connects young Black and Latino gay and bisexual men to peer ambassadors using popular social networking apps to support conversations about sexual health and community resources.
An interdisciplinary team from YSPH worked with a panel of representatives of community agencies from around Connecticut to develop the Community Research Activity Assessment Tool (CREAT), which assesses the capacity of community-based organizations’ research activity and capacity. This tool can be used to identify areas where additional capacity is needed, as well as help guide community and research partnerships and needs.
In collaboration with Brown University and The Institute for Community Research (ICR), CIRA conducted a pilot study examining implementation strategies and effectiveness of Partner Notification Services among HIV-positive men who have sex with men (MSM) in Connecticut, Rhode Island and Massachusetts. Interviews with Disease Intervention Specialists (DIS) focused on current PS protocols and outcomes for each state, and interviews with HIV-positive MSM who had participated in PS for HIV and other sexually transmitted infections (STIs) explored their experiences and preferences.
In the fall of 2020, The Center for Interdisciplinary Research on AIDS and the Center for Methods in Implementation and Prevention Science (CMIPS) were granted a NIH Implementation Science Consultation Hub Supplement to Support the Ending the HIV Epidemic Initiative.
Work in Uganda informs national-implementation guidelines on evidence-based TB interventions.
Research in humanitarian settings addresses HIV risk factors
The ESTEEM program provides evidence-based approaches to improving mental health and reducing stigma among people who identify as LGBTQ. Their project includes LGBTQ-affirming psychotherapy programs.